Individual provider Active NPI

Allison Callaway Herrin, CCC-SLP

  • Speech-Language Pathologist
  • Waycross, GA
National Provider Identifier
1518928043
Registry record updated Mar 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
005005 Issued in GA
Practice address
303 Pineview Dr
Waycross, GA 31501-5229
Phone
(912) 283-0777
Fax
(912) 283-7757
NPI assigned
Apr 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 005005 GA Primary

Addresses

Primary practice location

303 Pineview Dr
Waycross, GA 31501-5229

Mailing address

5844 Jessica LN
Patterson, GA 31557-2672
Phone (912) 614-7847

Other identifiers 1

IdentifierTypeStateIssuer
000944446AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090828000402 GA Practitioner - Qualified Speech Language Pathologist 0648325571 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

155 E Cherry St
Jesup, GA 31546-4666
Phone (912) 427-0447

303 Pineview Dr
Waycross, GA 31501-5229
Phone (912) 283-0777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Speech-Language Pathology Contractors, Inc. Speech-Language Pathologist CurrentSince Jun 2, 2009 Accepting new patients
Speech Clinic LLC Speech-Language Pathologist PastSince Apr 1, 2009 Accepting new patients
Speech Clinic of the Coastal Empire LLC Speech-Language Pathologist PastSince Jul 13, 2023 Accepting new patients

Locations

1507 Alice St
Waycross, GA 31501
Phone (912) 283-7220

303 Pineview Dr
Waycross, GA 31501
Phone (912) 283-0777

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490659200000",
    "number": "1518928043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5844 JESSICA LN",
            "city": "PATTERSON",
            "state": "GA",
            "postal_code": "315572672",
            "telephone_number": "912-614-7847",
            "fax_number": "912-283-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 PINEVIEW DR",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315015229",
            "telephone_number": "912-283-0777",
            "fax_number": "912-283-7757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRIN",
        "first_name": "ALLISON",
        "middle_name": "CALLAWAY",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-02",
        "last_updated": "2017-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "005005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000944446A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waycross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.